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在麻醉的开胸猫中,心脏自主神经受刺激时的血流动力学反应。

Haemodynamic responses to stimulation of the cardiac autonomic nerves in the anaesthetized cat with closed chest.

作者信息

Barnes R J, Bower E A, Rink T J

出版信息

J Physiol. 1980 Feb;299:55-73. doi: 10.1113/jphysiol.1980.sp013110.

Abstract
  1. The changes in cardiac output and mean right atrial pressure (R.A.P.) evoked by stimulation of the cardiac autonomic nerves were investigated in cats under chloralose anaesthesia, with unopened chests and spontaneous respiration, and with active vascular reflexes. Cardiac output was measured by thermal dilution; the technique used was calibrated against the direct Fick method.2. The initial values of R.A.P. and output were varied by infusion of dextran-saline solution followed by withdrawal of blood. At positive values of R.A.P. withdrawal of blood caused a fall in R.A.P. with no change in cardiac output. At negative R.A.P. blood withdrawal caused a fall in output with little change in R.A.P.: the linear regression coefficient for output on R.A.P. was 48.2 ml./min.kg.mmHg (S.E. 2.06, n = 63, nine cats).3. Stimulation of the right cardiac sympathetic nerve increased heart rate by 69.2 beats/min (S.E. 4.0) from the resting rate of 158 beats/min (S.E. 6.3, ten cats). The acceleration was accompanied in most instances by a rise in cardiac output and a fall in R.A.P. and the magnitude of the rise in output was related to that of the fall in R.A.P.4. In no experiment could R.A.P. be reduced below -2.5 mmHg either by withdrawal of blood or by sympathetic stimulation. At negative values of R.A.P. the fall in R.A.P. and rise in output evoked by sympathetic stimulation were small; substantial changes could be obtained only from positive initial values of R.A.P. The proportional increase in output evoked by a given proportional increase in heart rate during near-maximal sympathetic stimulation had a linear relationship to the initial value of R.A.P. over the range -2 to +8 mmHg. The output increment was less than proportional to the rate increment at all values of R.A.P. below +3 mmHg.5. In five experiments stimulation of the left cardiac sympathetic nerve evoked a greater increase in output for a given increase in heart rate than did stimulation of the right nerve; on the other hand both nerves gave similar increments of output for a given fall in R.A.P.6. Stimulation of the distal end of the right vagus nerve slowed the heart and caused a fall in cardiac output and a rise in R.A.P. The change in output associated with a given change in R.A.P. was significantly greater (P = 0.05) during sympathetic than during vagal stimulation in 14 out of 18 tests; the difference increased as circulating volume was reduced.7. It is concluded that the relationship between cardiac output and R.A.P. during sympathetic and vagal stimulation is consistent with the hypothesis that neurally evoked changes in cardiac performance vary output mainly, but not exclusively, by inducing changes in R.A.P. which alter the pressure gradient for the return of blood to the right atrium from the periphery.
摘要
  1. 在氯醛糖麻醉下、开胸、自主呼吸且存在活跃血管反射的猫身上,研究了刺激心脏自主神经所引起的心输出量和平均右心房压力(R.A.P.)的变化。心输出量通过热稀释法测量;所采用的技术以直接菲克法进行校准。

  2. 通过输注葡聚糖 - 盐水溶液随后抽血来改变R.A.P.和心输出量的初始值。当R.A.P.为正值时,抽血导致R.A.P.下降而心输出量无变化。当R.A.P.为负值时,抽血导致心输出量下降而R.A.P.变化很小:心输出量相对于R.A.P.的线性回归系数为48.2毫升/分钟·千克·毫米汞柱(标准误2.06,n = 63,9只猫)。

  3. 刺激右侧心脏交感神经使心率从静息心率158次/分钟(标准误6.3,10只猫)增加69.2次/分钟(标准误4.0)。在大多数情况下,心率加快伴随着心输出量增加和R.A.P.下降,且心输出量增加的幅度与R.A.P.下降的幅度相关。

  4. 在任何实验中,无论是通过抽血还是交感神经刺激,R.A.P.都不能降至 - 2.5毫米汞柱以下。当R.A.P.为负值时,交感神经刺激引起的R.A.P.下降和心输出量增加都很小;只有从R.A.P.的正值初始值才能获得显著变化。在接近最大交感神经刺激期间,给定心率比例增加所引起的心输出量比例增加与R.A.P.的初始值在 - 2至 + 8毫米汞柱范围内呈线性关系。在R.A.P.低于 + 3毫米汞柱的所有值时,心输出量增加量与心率增加量不成比例。

  5. 在5个实验中,对于给定的心率增加,刺激左侧心脏交感神经比刺激右侧神经引起的心输出量增加更大;另一方面,对于给定的R.A.P.下降,两条神经引起的心输出量增加相似。

  6. 刺激右侧迷走神经远端使心率减慢,导致心输出量下降和R.A.P.升高。在18次测试中的14次中,交感神经刺激期间与给定R.A.P.变化相关的心输出量变化比迷走神经刺激期间显著更大(P = 0.05);随着循环血量减少,差异增大。

  7. 得出的结论是,交感神经和迷走神经刺激期间心输出量与R.A.P.之间的关系与以下假设一致,即神经诱发的心脏功能变化主要但并非唯一地通过引起R.A.P.变化来改变心输出量,R.A.P.变化会改变从外周回流到右心房的血液的压力梯度。

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